I went with VSG because their were fewer side effects for me to deal with, in addition to it not being as drastic. My surgeon retained the rights to change it at the last minute if he found issues (i.e. Esophagus issues).

I chose Vsg for all the same reasons listed above and have zero regret. I also only had 80-90 lbs to lose.

I had VSG instead of RNY because malabsorption is not a healthy way to maintain weight loss for most folks. I know a woman who had it, and she has had constant battles with anemia due to her iron levels and not staying strict with her vitamin supplementation. She is thinner than me, but looks sickly. I did not want that. Also, in my pre-surgery support group, there were a few who had RNY who said if they could go back in time and have the option to do VSG, they would have done so. I also previously had the lap band and it was horrible and useless for me.

At the time I was deciding, I was dating a guy who had the duodenal switch done (very drastic - basically its a combo of vsg and gastric bypass - sleeve instead of pouch and add in intestinal rerouting - restriction and malabsortion). The bathroom side effects of malabsorption are what convinced me to go more conservative. Malabsorption means stuff goes RIGHT through you basically in the same form it came in. If you eat something greasy, it comes out greasy. What comes out is basically undigested food. If you leave out undigested food it molds - digested food (i.e. normal poop) does not . So the toilet would get a mold ring around it from him. Also for most people who have any WLS, digestion issues cause gas. Sometimes it is not a big deal, but for a lot of RNY and DS people it is almost as socially debiliating as the weight was. Not only did he have a lot of gas, but that and his bowel movements have the absolute WORST smell ever. If you google it, you will see people desperate for solutions to that. Using a public restroom (i.e. at work) is incredibly embarassing for him. And finally, he lost a lot of weight extremely fast (i.e. 200 pounds in under a year)... but then he couldnt stop it. No matter how much he eats, it goes right through him. So he is underweight and "sickly" as someone mentioned since he also doesnt absorb vitamins (which generally happens in your intestines - but not for him). He can never take any time release based medicine - which most vitamins are... so he has to take vitamins 4 times a day for the rest of his life since he only absorbs a little of it.

Basically, he swapped one inconvenient/embarassing lifestyle for another inconvenient/embarassing lifestyle. I decided to not be so drastic. If the VSG didnt work, at least then I could have other options (do a mini RNY, etc).

Its a big decision and depends on what you are willing to trade. Not everyone will have such drastic changes, but unless you have a lot to lose and it is life threatening, its probably better to go a little more conservative route when possible. I dont regret the VSG one bit. I have a few tradeoffs and inconveniences, but for the most part I live a normal life now (4 years out).

I am going to post something about my decision that's probably going to sound trite to some: I prayed a lot about which surgery to have and I just did not have a feeling of peace about gastric bypass. It turned out after my surgery that they had found a tumor in my stomach which was removed during the surgery. I didn't even know about it until after 3 weeks after it was out. If I would have had gastric bypass, which I had absolutely no peace about, that stomach would have stayed there in that tumor would have stayed there and grown.

I started down the road of VSG, but it turned out that I had quite an advanced case of Barret's Esophagus. My surgeon advised that RNY would lessen the chances of future damage due to the common occurrence of GERD with VSG and he was able to resect the main damage that I had already.